Development and validation of the peptic ulcer scale under the system of quality of life instruments for chronic diseases based on classical test theory and generalizability theory

Applying the Generalizability Theory to Identify the Sources of Validity Evidence for the Quality of Communication Questionnaire

Effective doctor-patient-family communication is an integral and sensitive part of health care, assessing its quality is essential to identify aspects needing disclosure and, if necessary, improvement. Cross-sectional study aimed to analyze the sources of evidence of validity and the number of participants needed to reliably apply the Quality of Communication Questionnaire (QoC) through Generalizability Theory (GT). The mean age of the 150 patients hospitalized at the end of life was 50.5 (SD = 13.8) years, the mean hospital length of stay was 7.5 (SD = 10.2) days, 56.9% were male. Regarding the 105 patients' family members of patients whose mean length of hospital stay was 9.5 (SD = 9.1) days, their mean age was 42.2 (SD = 14.7) years, 69.5% were female. GT was used to quantify the minimum number of questionnaires needed, with the aim of reaching a reliable estimate of QoC with G-coefficients. To reach a reliability of .90, there is a need for 25 for the Eρ2 questionnaires and 35 for the Φ. The exact estimation identified the minimum number of questionnaires required for the evaluation of physicians by patients. To obtain a reliability of .90, there is a need for 30 and 40 questionnaires for the G-coefficients. A practical and fast application makes it possible to use QoC in its entirety or alone to evaluate general communication or communication about palliative care. Furthermore, based on these results, it was possible to identify which aspects were effective or ineffective in these contexts.

Development and Validation of the Coronary Heart Disease Scale Among the System of Quality of Life Instruments for Chronic Diseases QLICD-CHD (V2.0) Based on Classical Test Theory and Generalizability Theory

Objective

Coronary heart disease (CHD) is a common and frequent disease with a long and incurable course, and the quality of life of patients is severely reduced. This study was to develop and validate a quality of life scale for patients with CHD based on the Chinese context.

Methods

The scale QLICD-CHD (V2.0) was developed based on the QLICD-CHD (V1.0), using a programmed decision procedures. Based on the data measuring QoL 3 times before and after treatments from 189 patients with CHD, the psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation analysis, multi-trait scaling analysis, structural equation modeling, t-test and also G-study and D-study of generalizability theory analysis. The SF-36 scale was used as the criterion to evaluate the criterion-related validity. Paired t tests were conducted to evaluate the responsiveness on each domain/facet as well as the total of the scale, with Standardized Response Mean (SRM) being calculated.

Results

The QLICD-CHD (V2.0) has been developed with 42 items in 4 domains. The Cronbach's α of the general module, the specific module and the total scale were 0.91, 0.92 and 0.91 respectively. The overall score and the test-retest reliability coefficients in all domains are higher than 0.60, except for the specific module. Correlation and factor analysis confirmed good construct validity and criterion-related validity. After treatments, the overall score and score of all domains have statistically significant changes (P<0.01). The SRM of domain-level score ranges from 0.27 to 0.50. Generalizability Theory further confirm the reliability of the scale through more accurate variance component studies.

Conclusion

The QLICD-CHD (V2.0) could be used as a useful instrument in assessing QoL for patients with CHD, with good psychometric properties.

Development and validation of the osteoporosis scale among the system of quality of life instruments for chronic diseases QLICD-OS (V2.0)

BACKGROUND

Quality of life of osteoporosis patients had caused widespread concern, due to high incidence and difficulty to cure. Scale specifics for osteoporosis and suitable for Chinese cultural background lacked. This study aimed to develop an osteoporosis scale in Quality of Life Instruments for Chronic Diseases system, namely QLICD-OS (V2.0).

METHODS

Procedural decision-making approach of nominal group, focus group and modular approach were adopted. Our scale was developed based on experience of establishing scales at home and abroad. In this study, Quality of life measurements were performed on 127 osteoporosis patients before and after treatment to evaluate the psychometric properties. Validity was evaluated by qualitative analysis, item-domain correlation analysis, multi-scaling analysis and factor analysis; the SF-36 scale was used as criterion to carry out correlation analysis for criterion-related validity. The reliability was evaluated by the internal consistency coefficients Cronbach's α, test-retest reliability Pearson correlation r. Paired t-tests were performed on data of ​​the scale before and after treatment, with Standardized Response Mean (SRM) being calculated to evaluate the responsiveness.

RESULTS

The QLICD-OS, composed of a general module (28 items) and an osteoporosis-specific module (14 items), had good content validity. Correlation analysis and factor analysis confirmed the construct, with the item having a strong correlation (most > 0.40) with its own domains/principle components, and a weak correlation (< 0.40) with other domains/principle components. Correlation coefficient between the similar domains of QLICD-OS and SF-36 showed reasonable criterion-related validity, with all coefficients r being greater than 0.40 exception of physical function of SF-36 and physical domain of QLICD-OS (0.24). Internal consistency reliability of QLICD-OS in all domains was greater than 0.7 except the specific module. The test-retest reliability coefficients (Pearson r) in all domains and overall score are higher than 0.80. Score changes after treatment were statistically significant, with SRM ranging from 0.35 to 0.79, indicating that QLICD-OS could be rated as medium responsiveness.

CONCLUSION

As the first osteoporosis-specific quality of life scale developed by the modular approach in China, the QLICD-OS showed good reliability, validity and medium responsiveness, and could be used to measure quality of life in osteoporosis patients.

Analyzing and Comparing Univariate, Multivariate, and Bifactor Generalizability Theory Designs for Hierarchically Structured Personality Traits

We demonstrate how to use structural equation models to represent generalizability theory-based univariate, multivariate, and bifactor model designs. Analyses encompassed multi-occasion data obtained from the recently expanded form of the Big Five Inventory (BFI-2) that measures the broad personality domain constructs Agreeableness, Conscientiousness, Extraversion, Negative Emotionality, and Open-Mindedness along with three nested subdomain facets within each global domain. Results overall highlighted the importance of taking both item and occasion effects into account but underscored additional benefits of the multivariate and bifactor designs in providing more appropriate indices of generalizability for composite scores and effective ways to gauge subscale added value. Bifactor models further extended partitioning of universe score variance to separate general and group factor effects at both composite and subscale levels, expanded score consistency indices to distinguish or combine such effects, and allowed for further evaluation of score dimensionality and subscale viability. We provide guidelines, formulas, and code in R for analyzing all illustrated designs within the article and extended online Supplemental Material.

Morphology of the papilla can predict procedural safety and efficacy of ERCP-a systematic review and meta-analysis

Endoscopic Retrograde Cholangiopancreatography (ERCP) is the primary therapeutic procedure for pancreaticobiliary disorders, and studies highlighted the impact of papilla anatomy on its efficacy and safety. Our objective was to quantify the influence of papilla morphology on ERCP outcomes. We systematically searched three medical databases in September 2022, focusing on studies detailing the cannulation process or the rate of adverse events in the context of papilla morphology. The Haraldsson classification served as the primary system for papilla morphology, and a pooled event rate with a 95% confidence interval was calculated as the effect size measure. Out of 17 eligible studies, 14 were included in the quantitative synthesis. In studies using the Haraldsson classification, the rate of difficult cannulation was the lowest in type I papilla (26%), while the highest one was observed in the case of type IV papilla (41%). For post-ERCP pancreatitis, the event rate was the highest in type II papilla (11%) and the lowest in type I and III papilla (6-6%). No significant difference was observed in the cannulation failure and post-ERCP bleeding event rates between the papilla types. In conclusion, certain papilla morphologies are associated with a higher rate of difficult cannulation and post-ERCP pancreatitis.

Efficacy of emotion regulation training on pain intensity and life quality in patients with peptic ulcer disease (PUD)

Aim

Because gastric ulcer is a psychosomatic disease involving many psychological factors like assertiveness and cognitive beliefs, this study aimed to investigate the effectiveness of emotion regulation training on pain intensity and quality of life in patients with peptic ulcer disease.

Background

Gastric ulcer, a recurrent and common disease worldwide, is associated with gastrointestinal symptoms and lower health-related quality of life. Psychological factors and stress have been recognized as important contributors to the onset and duration of gastric ulcer, highlighting the need for effective psychological interventions to improve pain intensity and quality of life in patients.

Methods

The research method was semi-experimental and based on the pretest-posttest control group design, with follow-up after three months. The sample included 46 participants selected by a Purposive Sampling method and placed randomly in the experimental and control groups. At first, simultaneously, and under the same conditions, all the participants responded to the Chronic Pain Grade Questionnaire (CPG) and Quality of Life Questionnaire (SF-12). The emotion regulation training was performed on the experimental group. In the end, both groups were evaluated by posttests, and then they were tracked after three months. To analyze data, the ANCOVA test was applied through SPSS 22.

Results

Findings showed that emotion regulation training was meaningfully effective in decreasing pain intensity and increasing life quality (p<0.01), but after three months interval, no significant changes were found in the results.

Conclusion

Due to the results about emotion regulation training protocol that has successfully reduced pain intensity symptoms in PUD patients and increased life quality, it is suggested that this protocol can be added to other treatments for PUD patients.

Development and preliminary validation of the chronic obstructive pulmonary disease scale quality of life instruments for chronic diseases-chronic obstructive pulmonary disease based on classical test theory and generalizability theory

Quality of life (QOL) in patients with Chronic obstructive pulmonary disease (COPD) is a major global concern in respiratory care with the specific instruments used rarely being developed using a modular approach. This paper is aimed to develop the COPD scale of the system of QOL Instruments for Chronic Diseases (QLICD-COPD) by the modular approach based on Classical Test Theory and Generalizability Theory (GT). 114 inpatients with COPD were used to provide the data measuring QOL three times before and after treatments. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation analysis, factor analyses, multi-trait scaling analysis, and also GT analysis. The Results showed that Multi-trait scaling analysis, correlation and factor analyses confirmed good construct validity and criterion-related validity with almost all correlation coefficients or factor loadings being above 0.40. The internal consistency α and test-retest reliability coefficients (Pearson r and Intra-class correlations ICC) for all domains except for the social domain were larger than 0.70, ranging between 0.70–0.86 with r = 0.85 for the overall. The overall score and scores for physical and the specific domains had statistically significant changes after treatments with moderate effect size SRM (standardized response mean) ranging from 0.32 to 0.44. All G-coefficients and index of dependability were all greater than 0.80 exception of social domain (0.546 and 0.500 respectively), confirming the reliability of the scale further. It concluded that the QLICD-COPD has good validity, reliability, and moderate responsiveness, and can be used as the QOL instrument for patients with COPD.